Håkon A. Johannessen

Effects of occupational role conflict and emotional demands on subsequent psychological distress: A 3-year follow-up study of the general working population in Norway

Objective: To examine the impact of occupational role conflict and emotional demands on subsequent psychological distress. Methods: A randomly drawn cohort from the general Norwegian working-age population was followed up for 3 years (n = 12,550; response rate = 67%). Eligible respondents were in paid work during the reference week in 2006 and 2009 or temporarily absent from such work (n = 6,745; response rate = 68%). Results: In the fully adjusted model, both high role conflict (odds ratios = 1.53; 95% CI = 1.15 to 2.03) and high emotional demands (odds ratios = 1.38; 95% CI = 1.13 to 1.69) were significant predictors of psychological distress. Additional significant predictors were low job control, bullying/harassment, and job insecurity (P < 0.05). Conclusions: Considering all of the evaluated work-related factors, role conflict and emotional demands contributed the most to the population risk of developing psychological distress.

Systematic review of the cardiovascular effects of occupational noise

BACKGROUND Cross-sectional studies of occupational noise and cardiovascular effects show an association between noise and hypertension but for coronary heart disease or other cardiovascular diseases (CVDs) the evidence is not convincing. AIMS To assess possible associations between occupational noise exposure and the risk for cardiovascular effects in follow-up studies published after 1999. METHODS We performed a systematic critical literature review of original articles from key literature databases of associations between workplace noise and health. The studies were identified by search in Ovid Medline, Ovid Embase, Web of Science, Scopus and ProQuest Health and Safety Sciences Abstracts. We selected prospective studies of adequate quality with a measure of association between occupational noise exposure and cardiovascular health for the meta-analysis. RESULTS Twelve papers, all prospective and mostly with high quality but with methodological shortcomings in exposure assessment, were included in the review and meta-analysis. Exposure to noise at work was consistently positively associated with hypertension [Hazard ratio (HR) = 1.68; 95% confidence interval (CI) 1.10-2.57] and CVD [relative risk (RR) = 1.34; 95% CI 1.15-1.56]. In addition, we found a trivial effect of noise exposure on CVD mortality (HR = 1.12; 95% CI 1.02-1.24). CONCLUSIONS Occupational noise exposure is strongly associated with hypertension. For other cardiovascular effects, this meta-analysis suggests a weak association, but the evidence is limited. More longitudinal studies on the effects of occupational noise on the cardiovascular system are warranted.

Work-related psychosocial and organizational risk factors for headache: A 3-year follow-up study of the general working population in Norway

Objectives: To determine the effects of work-related psychosocial and organizational factors on headache. Methods: A random cohort from the Norwegian general population (aged 18 to 66 years) had been observed for 3 years. Eligible respondents answered a question about headache, and were engaged in paid employment during the reference weeks in 2006 and 2009, or were temporarily absent from such work (N = 3325). Results: In the fully adjusted model, the main risk factors were high role conflict (highest odds ratio [OR] = 2.86; 95% confidence interval [CI] = 1.49 to 5.48), low social climate (highest OR = 2.21; 95% CI = 1.09 to 4.49), bullying/harassment (OR = 3.94; 95% CI = 1.36 to 11.42), and downsizing (OR = 2.38; 95% = 1.20 to 4.71). Conclusions: Role conflict, low social climate, and bullying/harassment were the main predictors of headaches. These factors should be considered to prevent headaches at work.

The contribution from psychological, social, and organizational work factors to risk of disability retirement: a systematic review with meta-analyses

BackgroundPrevious studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability.The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses.MethodsData sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies. Data extraction: Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality. Data synthesis: We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study’s sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries.ResultsThere was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior.ConclusionsPsychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.

Work-related psychosocial risk factors for long-term sick leave: a prospective study of the general working population in Norway.

Objective: To examine the effect of work-related psychosocial exposures on long-term sick leave (LTSL) in the general working population. Methods: A prospective study of the general working population in Norway. Eligible respondents were interviewed in 2009 and registered with at least 100 working days in 2009 and 2010 (n = 6758). The outcome was medically confirmed LTSL of 40 days or more during 2010. Results: In the fully adjusted model, high exposure to role conflict (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.20 to 2.09), emotional demands (OR, 1.32; 95% CI, 1.03 to 1.69), and low supportive leadership (OR = 1.50; 95% CI, 1.15 to 1.96) predicted LTSL. A test for trend was statistically significant for all factors (P ⩽ 0.05). We estimated that 15% of LTSL cases were attributable to these factors. Conclusions: This study underlines the importance of taking into account psychosocial exposures as risk factors for LTSL.

Do work-related mechanical and psychosocial factors contribute to the social gradient in long-term sick leave: A prospective study of the general working population in Norway

Aims: A social gradient in long-term sick leave (LTSL) rates is well established, but only a few studies have examined to what extent this gradient may be explained by mechanical and psychosocial work environment factors. Methods: A randomly drawn cohort from the general population in Norway, aged 18–69 years, was interviewed in the second half of 2009 (n=12,255, response at baseline 60.9%) and followed up in national registries to the end of 2010. Eligible respondents were registered with an active employee relationship of at least 100 actual working days in 2009 and 2010 (n=6758). Based on administrative register data, respondents were coded into five educational levels (university/college ≥4 years was set as the reference group). Eight work-related psychosocial factors and 10 mechanical exposures were measured. The outcome of interest was medically confirmed LTSL ≥40 working days during 2010. Results: In total, 9.4% (635 individuals) were classified with LTSL during 2010. There was a strong social gradient ranging from 12.4% (elementary) to 3.3% (university/college ≥4 years) among men. The corresponding figures among women were 15.4 and 4.6%. Adjusting for work-related mechanical and psychosocial factors explained between 41 and 44% of the social gradient in men. Among women, the corresponding figures were 31 and 54%. Conclusions: Work-related mechanical and psychosocial factors contribute to the social gradient in LTSL. The work-related factors that accounted for this gradient were rather similar for men and women.

Do Work-Related Mechanical and Psychosocial Factors Contribute to the Social Gradient in Low Back Pain?: A 3-Year Follow-Up Study of the General Working Population in Norway.

Study Design. A prospective cohort study. Objective. The aim of the study was to investigate the extent to which work-related factors contribute to the social gradient in low back pain (LBP). Summary of Background Data. A social gradient in LBP is well established, but only a few studies have examined the extent to which exposure to mechanical and psychosocial work environment factors is a pathway for this gradient. Methods. A randomly drawn cohort from the general population in Norway aged 18 to 66 years was followed up for 3 years (n = 12,550, response rate at baseline = 67%). Eligible respondents were in paid work during 2006 and 2009 (n = 6819). Based on administrative register data respondents were coded into five educational levels (university/college ≥4 years was set as the reference group). Outcome of interest was self-reported moderate or severe LBP at follow-up adjusted for baseline LBP. Results. In total, 11.2% (397 individuals) men and 14.5% (461 individual) women reported LBP at follow-up. There was a strong social gradient ranging from 16.4% (elementary) to 6.4% (university/college ≥4 years). The corresponding figures among women were 22.4% and 7.5%. Corrected for age, LBP at baseline and working hours, educational level was a significant predictor of LBP at follow-up (odds ratios 1.8–2.3 in men and 1.7–3.1 in women). Adjusting for mechanical factors reduced the gradient by 39% to 43% in men and 28% to 34% in women. Adjusting for psychosocial factors reduced the gradient by 5% to 12% in men and increased the gradient by 7% to 11% in women. Conclusion. Work-related mechanical factors contributed substantially to the social gradient in LBP among both men and women. The impact of psychosocial factors was modest among men and contributed to an increased gradient among women. Level of Evidence: 3

Self-reported Occupational Exposure to Chemical and Physical Factors and Risk of Skin Problems: A 3-year Follow-up Study of the General Working Population of Norway

Prospective studies on occupational dermatoses in the general working population are sparse. This study investigated prospectively the impact of self-reported occupational exposure to chemicals and physical factors on the risk of skin problems. The cohort comprised respondents drawn randomly from the general population in Norway, who were registered employed in 2006 and 2009 (n = 6,745). Indoor dry air (odds ratio (OR) 1.3; 95% confidence interval (95% CI) 1.1-1.6) was a significant baseline predictor of skin problems at follow-up, whereas exposure to cleaning products (OR 1.7; 95% CI 1.2-2.5), water (OR 1.4; 95% CI 1.1-1.9) and indoor dry air (OR 1.6; 95% CI 1.1-2.1) at both measurement time-points was significantly associated with skin problems. The population risk attributable to these factors was 16%. This study quantified the contribution of occupational exposure factors to skin problems in the general working population of Norway.

Influence of occupational factors on regional differences in sick leave: A prospective population study:

Aims: Number of sick leave days vary by county, but little is known about the extent to which this gradient may be explained by differences pertaining to occupational composition and occupational exposure. Methods: A randomly drawn cohort from the general population in Norway, aged 18–69 years, was interviewed by telephone in the second half of 2009 (n=12,255; response at baseline=60.9%) and followed up in national registries to the end of 2010. Eligible respondents were registered with an active employee relationship in 2009 and 2010 (n=8275). Information on counties (n=19) was based on the administrative register. The outcome of interest was the number of physician-certified sick-leave days divided by scheduled man-days during 2010 (i.e. sick-leave percentage (SLP)). Results: The average SLP during 2010 was 5.2%. The between-county variation in SLP ranged from 4.0% to 7.2%. Compared to the age- and gender-adjusted model, adjustment for occupation, economic sector and self-reported occupational exposure reduced the median difference in SLP between the county with the lowest SLP (reference county) and the SLP in the other counties by 1.08 percentage points (i.e. a 58% reduction). The impact of occupational composition and occupational exposure on the total between-county variance in SLP was a 16% reduction. Conclusions: Occupational composition and self-reported occupational exposure help to explain a significant part of the difference in SLP between counties, and appear to be more important explanatory factors than demographic variables, self-reported health and smoking.

Self-reported occupational skin exposure and risk of physiciancertified long-term sick leave: A prospective study of the general working population of Norway

Little is known about the contribution of occupational skin exposure as a risk factor for physician-certified long-term sick leave in the general working population of Norway. This study drew a cohort (n = 12,255; response at baseline 69.9%) randomly from the general population of Norway. Occupational skin exposure (in 2009) was measured based on 5 items. The outcome of interest was physician-certified long-term sick leave ≥ 16 days during 2010. Statistical adjustment for psychosocial and mechanical occupational exposures was performed. Long-term sick leave was predicted by occupational skin exposure to cleaning products (odds ratio (OR) 1.7; 95% confidence interval (95% CI) 1.1-2.5) and waste (OR 2.1; 95% CI 1.1-3.7) among men, and occupational skin exposure to water (OR 1.3; 95% CI 1.0-1.6) among women. The estimated population attributable risk for occupational skin exposure was 14.5%, which emphasizes its contribution as an important risk factor for long-term sick leave.